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Late in a game against the San Diego Padres on May 9, Miami Marlins superstar pitcher Jose Fernandez noticed the velocity on his fastball dropping sharply. At the time, his team thought an unsettled stomach was slowing him down, but later learned that the problem was a torn ulnar collateral ligament in his throwing elbow.

The injury is as serious as it sounds. Recovery means surgery to replace the ligament, a process that will sideline him for roughly a year and could cost him millions of dollars in salary while also costing his team dearly in lost revenue.

Fernandez and the Marlins aren’t alone. Current Blue Jays starter Drew Hutchison had the surgery in 2012, as did former rotation-mate Kyle Drabek, who is pitching for the Jays Triple-A team in Buffalo as he attempts to come back. Josh Johnson, who pitched for the team last year before signing with San Diego Padres, had the surgery this year.

Hardball Times baseball writer Jon Roegele calculates that 39 major league and minor league pitchers have had elbow ligament replacement surgery since February. Anecdotal evidence suggests the injury and the surgery to correct it are increasingly common at all levels of the sport, and research from American Sports Medicine Institute supports those observations.

As more pitchers suffer torn elbow ligaments, the ramifications accrue for both the game and the business of baseball. Whether the injured player is a seasoned pro or a high school hurler, ASMI research director Glenn Fleisig says there’s economic fallout when the repetitive strain of pitching a baseball blows out an elbow ligament.

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“If you have a professional player with a $5 million contract, it’s costing somebody $5 million to pay a guy not to play,” Fleisig says. “When you have a high school junior who blows out his arm, the surgery costs several thousand dollars, but he also lost the opportunity to play his senior year and maybe his career is over. For the high school player, the financial cost of the surgery is higher because his salary is zero.”

Whether or not the surgery — nicknamed “Tommy John” after the Yankees pitcher who was the first to undergo it — affects a player’s earning power can depend on the stage of his career. Most players who have the surgery return to their previous level of performance and are compensated accordingly.

“A.J. Burnett had Tommy John (surgery) with the Marlins and had that big contract with us,” says Blue Jays general manager Alex Anthopoulos. “There are plenty of guys who have hit free agency” and not been affected. “But does it impact you going into arbitration because you don’t pitch? Sure.”

That’s the scenario for Fernandez, who has completed just one major league season. After the 2015 season, he and the Marlins will meet with an arbitrator to negotiate an increase in his $635,000 (U.S.) salary.

A recent essay on the baseball stats web site fangraphs.com points out that a healthy Fernandez could have demanded a figure similar to the $4.35 million Tampa Bay Rays star David Price won his first year in arbitration. But Fernandez’ injury means he’ll lack Price’s track record, and the subsequent lack of negotiating leverage could cost him millions.

The Marlins, meanwhile, will lose big at the gate, where Fernandez has been the club’s biggest attraction. This season, the team is averaging 21,437 spectators at home games, but 28,923 on days Fernandez pitches. Wiping 10 Fernandez games off the Marlins remaining home schedule could cost the team nearly 76,000 customers — the equivalent of four home games.

Still, team president David Samson remains optimistic that Fernandez’ absence won’t hurt the marketing of the Marlins.

“He is one of the best pitchers in the game. Of course he was a draw,” he told the South Florida Sun-Sentinel. “We market individual players, but we also market the team. At the end of the day we market the ballpark, because the one constant, more than anybody, over the next 40 years, is Marlins Park.”

Fleisig stresses that teams could save money and protect multimillion-dollar investments by working to prevent elbow injuries at every level of the sport. The ASMI has published a list of recommendations that include strict pitch limits and a minimum two-month annual break from baseball for young players.

“If a team has a great secret on how to make a guy pitch faster or hit the ball farther (major league teams) have no incentive to share it,” Fleisig says, stressing that these injuries are preventable. “But when it gets to the medical side . . . the call is out here. It’s cheaper to solve a little problem than a big one.”

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